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Safety and Effectiveness Study of the Ensure Medical Vascular Closure Device

Primary Purpose

Angioplasty, Transluminal, Percutaneous Coronary, Coronary Arteriosclerosis, Peripheral Arteriosclerosis

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Manual Compression
Vascular Closure Device
Sponsored by
Cordis Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Angioplasty, Transluminal, Percutaneous Coronary focused on measuring Closure Device, Angiography, Angioplasty, Hemostasis, Heart Catheterization, Peripheral Angiography, Femoral Closure, Vascular Closure, Coronary Angiography

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Scheduled for a coronary or peripheral diagnostic or interventional procedure Able to undergo emergent vascular surgery if a complication requires it 6F arterial puncture located in the common femoral artery Femoral artery has a lumen diameter of at least 5 mm Exclusion Criteria: Arterial puncture in the femoral artery of both legs Prior target artery closure with any vascular closure device, or closure with manual compression within 30 days prior to catheterization Patients who bruise or bleed easily or with a history of significant bleeding or platelet disorders Acute ST-elevation myocardial infarction within 48 hours prior to catheterization Uncontrolled hypertension at time of vessel closure Elevated Activated Clotting Time at time of vessel closure Ineligible for in-catheterization lab introducer sheath removal Concurrent participation in another investigational device or drug trial Thrombolytic therapy, bivalirudin, other thrombin-specific anticoagulants, or low molecular weight heparin within 24 hours prior to catheterization Preexisting hematoma, arteriovenous fistula, or pseudoaneurysm at the vessel access site prior to femoral artery closure Prior femoral vascular surgery or vascular graft in region of access site Femoral artery is tortuous or requires an introducer sheath longer than 11 cm Fluoroscopically visible calcium, atherosclerotic disease, or stent within 1 cm of the puncture site that would interfere with the operation of the experimental device Difficulty in obtaining vascular access resulting in multiple arterial punctures and/or posterior arterial puncture Antegrade vascular puncture Body Mass Index over 40 kg/m^2 Symptomatic leg ischemia in the target limb including severe claudication or weak/absent pulse Femoral artery diameter stenosis exceeding 50% Pre-existing severe non-cardiac systemic disease or terminal illness Planned arterial access at the same access site within 30 days of catheterization Extended hospitalization (e.g. Coronary Artery Bypass Graft (CABG) surgery) Pre-existing systemic or cutaneous infection Prior use of an intra-aortic balloon pump through the arterial access site Cardiogenic shock during or immediately following the catheterization Patient is unable to ambulate at baseline Patient is known or suspected to be pregnant or is lactating Patient is unavailable for follow-up Any angiographic or clinical evidence that the physician feels would place the patient at increased risk with the use of the experimental device

Sites / Locations

  • Mayo Clinic Hospital
  • University of California Davis Medical Center
  • Sutter Memorial Hospital
  • Stanford University
  • Morton Plant Hosptial
  • The Care Group
  • Washington University School of Medicine at Barnes-Jewish Hospital
  • Cooper Health Systems
  • SJH Cardiology Associates
  • New York Presbyterian Hospital - Cornell Medical College of Cornell University
  • Wake Heart Research
  • University Hospitals of Cleveland
  • Hahnemann Hospital
  • Moffitt Heart & Vascular Group
  • Baylor Research Institute
  • LDS Hospital
  • Swedish Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Manual Compression

Vascular Closure Device

Arm Description

Manual compression (MC)

Vascular Closure Device (VCD)

Outcomes

Primary Outcome Measures

Time to Hemostasis (TTH)
Time to hemostasis is defined as time (in minutes) from when the introducer sheath was removed to the time that hemostasis was first observed during post-procedure follow up. Hemostasis is defined as no or minimal subcutaneous oozing and the absence of expanding or developing hematoma. Time to hemostasis is one of the two co-primary endpoints.
Time to Ambulation (TTA)
Time to ambulation is defined as the time from when the introducer sheath was removed to the time that ambulation was achieved. Ambulation is defined as patient standing and walking at least 20 feet without re-bleeding or significant oozing requiring manual compression. Time to ambulation is one of the two co-primary endpoints.
Percentage of Patients Who Experience Any Vascular Closure Related Major Adverse Events During the 30 Days Post-procedure
Vascular closure related major adverse events consist of any of the events below: Vascular repair or the need for repair; access site-related bleeding requiring transfusion; access site-related infection requiring intravenous/intramuscular antibiotics and/or extended hospitalization; any new ipsilateral lower extremity ischemia documented by symptoms, physical exam, and/or decreased or absent blood flow on lower extremity angiogram; surgery for access site-related nerve injury; and Permanent (> 30 days) access site-related nerve injury.

Secondary Outcome Measures

Time to Eligibility for Hospital Discharge
Time to Eligibility for Hospital Discharge is measured from the time of sheath removal to the time when the patient is eligible for discharge according to the judgment of the patient's physician.
Time to Hospital Discharge
Time to hospital discharge is defined as from the time of sheath removal to the time of hospital discharge
Time to Device Deployment, up to 5 Minutes
Time to device deployment is defined as from the time device inserted to the time sheath removed
Percentage of Patients Who Achieved Device Success Within Five Minutes Post-procedure
Device Success is defined as the successful deployment of the plug, initial hemostasis time less or equal to 5 minutes, and removal of the intact delivery system.
Percent of Patients Who Achieved Procedure Success During 30 Days Post-procedure
Procedure success is defined as initial hemostasis achieved by the assigned method Vascular Closure Device (VCD) or Manual compression (MC) with none of the primary safety endpoint's closure related major adverse events (MAE). Procedural success is assessed on day of catheterization procedure and at 30 days post-procedure.
Percentage of Patients Who Experienced Any Other Vascular Closure Related Adverse Events
Other known vascular closure related adverse events include: Rebleeding Following Initial Hemostasis; Access Site Hematoma >= 6cm; Access Site-Related Bleeding Requiring > 30 min for Hemostasis; Transient Access Site-Related Nerve Injury; Retroperitonea Bleeding; Decrease in Pedal Pulse

Full Information

First Posted
June 26, 2006
Last Updated
May 25, 2012
Sponsor
Cordis Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT00345631
Brief Title
Safety and Effectiveness Study of the Ensure Medical Vascular Closure Device
Official Title
ECLIPSE Trial - Ensure's Vascular Closure Device Speeds Hemostasis Trial
Study Type
Interventional

2. Study Status

Record Verification Date
May 2012
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
September 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Cordis Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether the Ensure Medical Vascular Closure Device is more effective than standard manual compression at sealing the puncture made in the femoral artery following a cardiac or peripheral diagnostic or interventional procedure while maintaining the same level of safety.
Detailed Description
Achieving hemostasis at the arterial puncture site after percutaneous cardiac catheterization is a potential cause of bleeding, hematomas, pseudoaneurysms, and various other vascular complications. Hemostasis at the femoral artery access site after diagnostic or interventional procedures is typically achieved using either manual compression or the deployment of a vascular closure device. Manual compression is time consuming for the health-care provider, and painful for the patient. In addition, prolonged periods of immobilization and bed rest may be required. Vascular closure devices have been developed to avoid manual compression, shorten bed rest, and allow earlier ambulation. The Ensure Medical Vascular Closure device (VCD) is intended for femoral artery puncture site closure in patients who have undergone coronary or peripheral diagnostic or interventional procedure using a standard 6F introducer sheath. The device is comprised of a bio-absorbable plug and a plug delivery system. The plug delivery system is designed to position the bio-absorbable plug to the extravascular surface of the femoral artery access site, facilitating a hemostasis response. The Ensure Medical VCD has been studied in a prior feasibility trial of 149 patients, which demonstrated that: (1) the device could be used to successfully obtain rapid hemostasis and early ambulation in patients undergoing catheterization procedures; and (2) the low incidence and relatively minor nature of the observed closure related complications suggests that the device is safe for its intended purpose. The ECLIPSE Trial is designed to evaluate the safety and effectiveness of the Ensure Medical VCD in comparison to standard manual compression. Patients will be randomly assigned to have their arterial access site closed using either manual compression or the VCD. The principal comparisons of the two closure techniques will include: Time required to obtain hemostasis of the vascular access site Time required for the patient to ambulate after their catheterization Frequency of occurrence of serious closure-related complications

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Angioplasty, Transluminal, Percutaneous Coronary, Coronary Arteriosclerosis, Peripheral Arteriosclerosis
Keywords
Closure Device, Angiography, Angioplasty, Hemostasis, Heart Catheterization, Peripheral Angiography, Femoral Closure, Vascular Closure, Coronary Angiography

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
488 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Manual Compression
Arm Type
Active Comparator
Arm Description
Manual compression (MC)
Arm Title
Vascular Closure Device
Arm Type
Experimental
Arm Description
Vascular Closure Device (VCD)
Intervention Type
Other
Intervention Name(s)
Manual Compression
Intervention Description
Manual compression
Intervention Type
Device
Intervention Name(s)
Vascular Closure Device
Other Intervention Name(s)
Exoseal
Intervention Description
Investigational vascular closure device
Primary Outcome Measure Information:
Title
Time to Hemostasis (TTH)
Description
Time to hemostasis is defined as time (in minutes) from when the introducer sheath was removed to the time that hemostasis was first observed during post-procedure follow up. Hemostasis is defined as no or minimal subcutaneous oozing and the absence of expanding or developing hematoma. Time to hemostasis is one of the two co-primary endpoints.
Time Frame
From when the introducer sheath was removed to the time hemostasis was first observed
Title
Time to Ambulation (TTA)
Description
Time to ambulation is defined as the time from when the introducer sheath was removed to the time that ambulation was achieved. Ambulation is defined as patient standing and walking at least 20 feet without re-bleeding or significant oozing requiring manual compression. Time to ambulation is one of the two co-primary endpoints.
Time Frame
From when the introducer sheath was removed to 30 days post-procedure
Title
Percentage of Patients Who Experience Any Vascular Closure Related Major Adverse Events During the 30 Days Post-procedure
Description
Vascular closure related major adverse events consist of any of the events below: Vascular repair or the need for repair; access site-related bleeding requiring transfusion; access site-related infection requiring intravenous/intramuscular antibiotics and/or extended hospitalization; any new ipsilateral lower extremity ischemia documented by symptoms, physical exam, and/or decreased or absent blood flow on lower extremity angiogram; surgery for access site-related nerve injury; and Permanent (> 30 days) access site-related nerve injury.
Time Frame
From post-procedure to 30 days follow up
Secondary Outcome Measure Information:
Title
Time to Eligibility for Hospital Discharge
Description
Time to Eligibility for Hospital Discharge is measured from the time of sheath removal to the time when the patient is eligible for discharge according to the judgment of the patient's physician.
Time Frame
From introducer sheath removal to hospital discharge, up to 284 hours
Title
Time to Hospital Discharge
Description
Time to hospital discharge is defined as from the time of sheath removal to the time of hospital discharge
Time Frame
From introducer sheath removal to patient discharge
Title
Time to Device Deployment, up to 5 Minutes
Description
Time to device deployment is defined as from the time device inserted to the time sheath removed
Time Frame
From device inserted to introducer sheath removal
Title
Percentage of Patients Who Achieved Device Success Within Five Minutes Post-procedure
Description
Device Success is defined as the successful deployment of the plug, initial hemostasis time less or equal to 5 minutes, and removal of the intact delivery system.
Time Frame
Within 5 minutes post-procedure
Title
Percent of Patients Who Achieved Procedure Success During 30 Days Post-procedure
Description
Procedure success is defined as initial hemostasis achieved by the assigned method Vascular Closure Device (VCD) or Manual compression (MC) with none of the primary safety endpoint's closure related major adverse events (MAE). Procedural success is assessed on day of catheterization procedure and at 30 days post-procedure.
Time Frame
From catheterization procedure to 30 day post-procedure follow up
Title
Percentage of Patients Who Experienced Any Other Vascular Closure Related Adverse Events
Description
Other known vascular closure related adverse events include: Rebleeding Following Initial Hemostasis; Access Site Hematoma >= 6cm; Access Site-Related Bleeding Requiring > 30 min for Hemostasis; Transient Access Site-Related Nerve Injury; Retroperitonea Bleeding; Decrease in Pedal Pulse
Time Frame
From end of vessel closure procedure to 30 days post-procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Scheduled for a coronary or peripheral diagnostic or interventional procedure Able to undergo emergent vascular surgery if a complication requires it 6F arterial puncture located in the common femoral artery Femoral artery has a lumen diameter of at least 5 mm Exclusion Criteria: Arterial puncture in the femoral artery of both legs Prior target artery closure with any vascular closure device, or closure with manual compression within 30 days prior to catheterization Patients who bruise or bleed easily or with a history of significant bleeding or platelet disorders Acute ST-elevation myocardial infarction within 48 hours prior to catheterization Uncontrolled hypertension at time of vessel closure Elevated Activated Clotting Time at time of vessel closure Ineligible for in-catheterization lab introducer sheath removal Concurrent participation in another investigational device or drug trial Thrombolytic therapy, bivalirudin, other thrombin-specific anticoagulants, or low molecular weight heparin within 24 hours prior to catheterization Preexisting hematoma, arteriovenous fistula, or pseudoaneurysm at the vessel access site prior to femoral artery closure Prior femoral vascular surgery or vascular graft in region of access site Femoral artery is tortuous or requires an introducer sheath longer than 11 cm Fluoroscopically visible calcium, atherosclerotic disease, or stent within 1 cm of the puncture site that would interfere with the operation of the experimental device Difficulty in obtaining vascular access resulting in multiple arterial punctures and/or posterior arterial puncture Antegrade vascular puncture Body Mass Index over 40 kg/m^2 Symptomatic leg ischemia in the target limb including severe claudication or weak/absent pulse Femoral artery diameter stenosis exceeding 50% Pre-existing severe non-cardiac systemic disease or terminal illness Planned arterial access at the same access site within 30 days of catheterization Extended hospitalization (e.g. Coronary Artery Bypass Graft (CABG) surgery) Pre-existing systemic or cutaneous infection Prior use of an intra-aortic balloon pump through the arterial access site Cardiogenic shock during or immediately following the catheterization Patient is unable to ambulate at baseline Patient is known or suspected to be pregnant or is lactating Patient is unavailable for follow-up Any angiographic or clinical evidence that the physician feels would place the patient at increased risk with the use of the experimental device
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
S. Chiu Wong, MD
Organizational Affiliation
New York Presbyterian Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic Hospital
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
University of California Davis Medical Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Sutter Memorial Hospital
City
Sacramento
State/Province
California
ZIP/Postal Code
95819
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305-5218
Country
United States
Facility Name
Morton Plant Hosptial
City
Clearwater
State/Province
Florida
ZIP/Postal Code
33756
Country
United States
Facility Name
The Care Group
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
Washington University School of Medicine at Barnes-Jewish Hospital
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Cooper Health Systems
City
Camden
State/Province
New Jersey
ZIP/Postal Code
08103
Country
United States
Facility Name
SJH Cardiology Associates
City
Liverpool
State/Province
New York
ZIP/Postal Code
13088
Country
United States
Facility Name
New York Presbyterian Hospital - Cornell Medical College of Cornell University
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Wake Heart Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27610
Country
United States
Facility Name
University Hospitals of Cleveland
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44122
Country
United States
Facility Name
Hahnemann Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
Facility Name
Moffitt Heart & Vascular Group
City
Wormleysburg
State/Province
Pennsylvania
ZIP/Postal Code
17043
Country
United States
Facility Name
Baylor Research Institute
City
Dallas
State/Province
Texas
ZIP/Postal Code
75226
Country
United States
Facility Name
LDS Hospital
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84143
Country
United States
Facility Name
Swedish Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98117
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19695549
Citation
Wong SC, Bachinsky W, Cambier P, Stoler R, Aji J, Rogers JH, Hermiller J, Nair R, Hutman H, Wang H; ECLIPSE Trial Investigators. A randomized comparison of a novel bioabsorbable vascular closure device versus manual compression in the achievement of hemostasis after percutaneous femoral procedures: the ECLIPSE (Ensure's Vascular Closure Device Speeds Hemostasis Trial). JACC Cardiovasc Interv. 2009 Aug;2(8):785-93. doi: 10.1016/j.jcin.2009.06.006.
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Safety and Effectiveness Study of the Ensure Medical Vascular Closure Device

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